| NPI | 1154474583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Authorized Official/Officer 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 107.6) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-09-14 |